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Updated: Jun 21, 2026
07:35
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
The incudostapedial articulation: new concepts
Collin S Karmody1, Clarinda C Northrop, Stephen R Levine
1Department of Otolaryngolgy, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. ckarmody@tuftsmedicalcenter.org
Summary
The incudostapedial joint (ISJ) is a complex, bichambered articulation with a unique fibrous disk and capsule. This detailed anatomy suggests the ISJ functions as a single physiological entity.
Area of Science:
- Otolaryngology
- Anatomy
- Middle Ear Biomechanics
Background:
- The incudostapedial joint (ISJ) anatomy is poorly understood and debated.
- Previous studies have not fully elucidated the ISJ's detailed structure.
Purpose of the Study:
- To investigate the detailed anatomy of the incudostapedial joint (ISJ).
- To clarify the controversial aspects of ISJ morphology.
Main Methods:
- Analysis of 86 temporal bones from 51 human subjects (aged 12-104 years).
- Utilized light microscopy and 3D computer-based reconstructions.
Main Results:
- Identified the ISJ as a partially bichambered joint with a distinct fibrous articular disk.
- Described a novel concavity on the incus, incorporating part of the long process into the joint capsule.
- Characterized the stapedius muscle tendon attachment to the joint capsule.
Conclusions:
- The incudostapedial joint's intricate structure supports its consideration as a single, cohesive physiological unit.
- Re-evaluation of the ISJ as an integrated anatomical complex is warranted.
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